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Palandri L, Rocca L, Scasserra MR, Vigezzi GP, Odone A, Iughetti L, Lucaccioni L, Righi E. Investigating Eating Habits of Children Aged between 6 Months and 3 Years in the Provinces of Modena and Reggio Emilia: Is Our Kids' Diet Sustainable for Their and the Planet's Health? Healthcare (Basel) 2024; 12:453. [PMID: 38391828 PMCID: PMC10888164 DOI: 10.3390/healthcare12040453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
A healthy and balanced diet is crucial for children's well-being and aids in preventing diet-related illnesses. Furthermore, unhealthy dietary habits indirectly impact children's health, as the food industry stands as one of the primary drivers of climate change. Evidence shows the Mediterranean diet is sustainable for both children's and the planet's health. The aim of this cross-sectional study was to evaluate the eating habits of children aged between 6 months and 3 years, in the province of Modena and Reggio Emilia, in Italy, along with their adherence to the guidelines for a healthy diet, and examine the role of pediatricians in promoting knowledge about nutrition and sustainability. In our sample (218 children), most children exceeded the recommended meat and cheese intake, while consuming insufficient amounts of vegetables, fruit, and legumes. Vegetable and fruit consumption declined with the increase in age category while eating sweets, soft drinks, and processed food increased. Incorporating school meals' data into this analysis, we observed a modification in dietary compliance, characterized by an increase in meat and cheese consumption, alongside improvements in the intake of vegetables, fruits, fish, eggs, and legumes. This study suggests that supporting an integrated approach that combines social and educational initiatives is crucial. Future research should prioritize fostering sustainable eating habits within communities to facilitate dietary habits' transformation and encourage healthier lifestyles.
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Affiliation(s)
- Lucia Palandri
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Rocca
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Maria Rosaria Scasserra
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Giacomo Pietro Vigezzi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Collegio Ca' della Paglia, Fondazione Ghislieri, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Neonatology Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Laura Lucaccioni
- Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy
| | - Elena Righi
- Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy
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Sharma N, Chakole S, Wandile B. Uncovering the Cardiovascular Threat: A Comprehensive Examination of Liver Fibrosis and Subclinical Atherosclerosis in Non-alcoholic Fatty Liver Disease. Cureus 2023; 15:e46946. [PMID: 38021670 PMCID: PMC10640697 DOI: 10.7759/cureus.46946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) has emerged as a global epidemic intricately linked to the rising tide of obesity and metabolic syndrome. This comprehensive review delves into the complex web of relationships between NAFLD, liver fibrosis, and subclinical atherosclerosis, shedding light on their interplay, shared risk factors, and clinical implications. NAFLD encompasses a spectrum of liver conditions, from the benign non-alcoholic fatty liver (NAFL) to the more severe non-alcoholic steatohepatitis (NASH), characterized by inflammation and hepatocellular injury. Central to the discussion is the insidious development of liver fibrosis, the ominous harbinger of progressive liver damage, cirrhosis, and hepatocellular carcinoma. The increasing prevalence of NAFLD, now affecting a quarter of the global population, poses a significant public health challenge. Its association with obesity, insulin resistance, and metabolic syndrome highlights the multifactorial nature of this disease. However, NAFLD's repercussions extend beyond the liver. This review unveils a potent connection between NAFLD and subclinical atherosclerosis, the early precursor to cardiovascular disease. Individuals with NAFLD face an elevated risk of atherosclerosis, even without traditional cardiovascular risk factors. The intricate link between these two conditions is illuminated through shared pathophysiological pathways, including systemic inflammation, insulin resistance, and dyslipidemia. Understanding the interplay between liver fibrosis and subclinical atherosclerosis has profound clinical implications. Patients with advanced fibrosis or cirrhosis are not only at risk of liver-related complications but also of cardiovascular events. This necessitates a holistic approach to patient care, with lifestyle modifications and pharmacological interventions simultaneously managing both conditions. Physicians must prioritize early detection and collaborate across disciplines to provide comprehensive care. Looking ahead, the future holds promising avenues of research. Emerging areas include genetics and precision medicine, microbiome research, and epigenetics, which may unveil new therapeutic targets. Innovations in diagnostics and therapeutics, such as non-invasive biomarkers and combination therapies, offer hope for more effective management. Long-term outcomes and survivorship research will provide insights into the lasting impact of interventions. In conclusion, this review underscores the imperative of addressing liver fibrosis and atherosclerosis in the context of NAFLD. It is a call to action for healthcare professionals, researchers, and policymakers to work collaboratively, promote early detection, and advance our understanding of these interconnected conditions. By doing so, we can enhance patient outcomes and chart a course toward a healthier future for those grappling with NAFLD and its intricate web of consequences.
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Affiliation(s)
- Niketa Sharma
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swarupa Chakole
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Bhushan Wandile
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Mukanu MM, Mchiza ZJR, Delobelle P, Thow AM. Nutrition policy reforms to address the double burden of malnutrition in Zambia: a prospective policy analysis. Health Policy Plan 2023; 38:926-938. [PMID: 37452507 PMCID: PMC10506529 DOI: 10.1093/heapol/czad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/31/2023] [Accepted: 07/13/2023] [Indexed: 07/18/2023] Open
Abstract
The evolution of nutrition patterns in Zambia has resulted in the coexistence of undernutrition and overnutrition in the same population, the double burden of malnutrition. While Zambia has strong policies addressing undernutrition and stunting, these do not adequately address food environment drivers of the double burden of malnutrition and the adolescent age group and hence the need for nutrition policy reforms. We conducted a theory-based qualitative prospective policy analysis involving in-depth interviews with nutrition policy stakeholders and policy document review to examine the feasibility of introducing nutrition policy options that address the double burden of malnutrition among adolescents to identify barriers and facilitators to such policy reforms. Using the multiple streams theory, we categorized the barriers and facilitators to prospective policy reforms into those related to the problem, policy solutions and politics stream. The use of a life-course approach in nutrition programming could facilitate policy reforms, as adolescence is one of the critical invention points in a person's lifecycle. Another key facilitator of policy reform was the availability of institutional infrastructure that could be leveraged to deliver adolescent-focused policies. However, the lack of evidence on the burden and long-term impacts of adolescent nutrition problems, the food industry's strong influence over governments' policy agenda setting and the lack of public awareness to demand better nutrition were perceived as critical barriers to policy reforms. In addition, the use of the individual responsibility framing for nutrition problems was dominant among stakeholders. As a result, stakeholders did not perceive legislative nutrition policy options that effectively address food environment drivers of the double burden of malnutrition to be feasible for the Zambian context. Policy entrepreneurs are required to broker policy reforms that will get legislative policy options on the government's agenda as they can help raise public support and re-engineer the framing of nutrition problems and their solutions in Zambia.
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Affiliation(s)
- Mulenga Mary Mukanu
- School of Public Health, University of the Western Cape, Bellville, Cape Town 7535, South Africa
| | - Zandile June-Rose Mchiza
- School of Public Health, University of the Western Cape, Bellville, Cape Town 7535, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
| | - Peter Delobelle
- Chronic Disease Initiative for Africa, University of Cape Town, Cape Town 7700, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, NSW 2006, Australia
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Mihaylova D, Popova A, Goranova Z, Doykina P, Goranov B. Characterization of Muffins Reformulated with Chia and Lyophilized Peach Powder in Terms of Some Technological and Sensory Aspects. Food Technol Biotechnol 2023; 61:273-282. [PMID: 38022882 PMCID: PMC10666944 DOI: 10.17113/ftb.61.03.23.7843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/12/2023] [Indexed: 02/21/2023] Open
Abstract
Research background There is an increasing interest in foods with added nutritional value. This study presents the opportunity for the reformulation of muffins using chia seeds and lyophilized peach powder in view of the emerging societal challenges regarding unhealthy eating patterns and food intolerances. Experimental approach Two new formulations were developed to eliminate the use of eggs and alter the flour content and type. Physical characteristics, texture analysis, water activity, microbial load, antioxidant potential and sensory profile aided in the evaluation of the newly developed products. Results and conclusions The results indicate an inversely proportional relationship between the relative mass of the dough and physical parameters (density, volume and height) of all muffin formulations. The modification of the original recipe compared to the control sample led to decreased baking losses, increased total phenolic content, as well as enhanced nutritional value in terms of fibre content. The addition of chia seeds and peach powder led to positive sensory changes. The alteration of the original recipe resulted in significant effect on the colour, making the muffins darker and less yellow than the control sample. In terms of texture characteristics, the new formulations had a profile close to the control. Novelty and scientific contribution Recipe reformulation without deteriorating quality attributes is important for the food technology field. Reformulation should comply with the new expectations of the modern consumer. The study targets an approach where new products with enhanced functional characteristics are presented.
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Affiliation(s)
- Dasha Mihaylova
- Department of Biotechnology, University of Food Technologies, 26 Maritsa Blvd., 4002 Plovdiv, Bulgaria
| | - Aneta Popova
- Department of Catering and Nutrition, University of Food Technologies, 26 Maritsa Blvd., 4002 Plovdiv, Bulgaria
| | - Zhivka Goranova
- Institute of Food Preservation and Quality, Agricultural Academy, 154 Vasil Aprilov str., 4002 Plovdiv, Bulgaria
| | - Pavlina Doykina
- Department of Catering and Nutrition, University of Food Technologies, 26 Maritsa Blvd., 4002 Plovdiv, Bulgaria
| | - Bogdan Goranov
- Department of Microbiology, University of Food Technologies, 26 Maritsa Blvd., 4002 Plovdiv, Bulgaria
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Ahmad R, Akter F, Haque M. Editorial: Diet and nutrition for non-communicable diseases in low and middle-income countries. Front Nutr 2023; 10:1179640. [PMID: 37057068 PMCID: PMC10088507 DOI: 10.3389/fnut.2023.1179640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
- Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, Bangladesh
| | - Farhana Akter
- Department of Endocrinology, Chittagong Medical College Hospital, Chattogram, Bangladesh
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
- *Correspondence: Mainul Haque ;
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Liu PL, Chang A, Liu MT, Ye JF, Jiao W, Ao HS, Hu W, Xu K, Zhao X. Effect of information encounter on concerns over healthy eating- mediated through body comparison and moderated by body mass index or body satisfaction. BMC Public Health 2023; 23:254. [PMID: 36747209 PMCID: PMC9901112 DOI: 10.1186/s12889-023-15069-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 01/17/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Understanding factors that influence healthy or unhealthy eating can inform intervention strategies. This study ascertained whether and how unintentional exposure to food and nutrition information influenced healthy eating concerns. The study tested body comparison, body satisfaction, and body mass index as three mechanisms that potentially link food information encounter, commonly known as information scanning, to healthy eating concerns. METHODS A sample of 440 online participants (mean age = 29.15 years) was used to investigate: (1) how unintentional exposure to food and nutrition information, i.e., information encounter (IE), affects healthy eating concerns (HEC); (2) how the effect of IE on HEC is mediated by body comparison (BC); (3) how the paths of the mediation model are moderated by body satisfaction (BS) or body mass index (BMI). RESULTS The findings show a positive and sizable total effect of IE on HEC - a whole-scale increase in information encounter is associated with a substantial increase in healthy eating concerns by 15 percentage points (bp = 0.150). BC is found to mediate the effect of IE on HEC in an all-positive complementary mediation. Both the indirect and the direct-and-remainder paths show sizable effects. The mediated path contributes about 20% of the total effect between IE and HEC (cp = 20%), while the direct-and-remainder path contributes the rest (cp = 80%). BS was found to moderate the relationship between IE and BC, the first leg of the mediation. The moderation effect is large - the effect of IE on BC is much smaller on the highly and the moderately satisfied than on the lowly satisfied (slope differential bp = -.60). BMI was found to moderate the direct-and-remainder effect of IE on HEC, controlling BC. That is, the effect of IE on HEC, after filtering out the mediated effect through BC, is much larger for those with high or low BMI than those with healthy BMI (slope differential bp = .32). CONCLUSIONS Exposure, even if unintentional, to food and nutrition information is an important predictor of HEC. BC, BS, and BMI are important factors that help to explain the process through which information affects behaviors.
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Affiliation(s)
- Piper Liping Liu
- Department of Communication / Institute of Collaborative Research, University of Macau, Macau, China.
| | - Angela Chang
- Department of Communication, University of Macau, Macau, China.
| | - Matthew Tingchi Liu
- grid.437123.00000 0004 1794 8068Department of Management and Marketing, University of Macau, Macau, China
| | - Jizhou Francis Ye
- grid.437123.00000 0004 1794 8068Department of Communication, University of Macau, Macau, China
| | - Wen Jiao
- grid.437123.00000 0004 1794 8068Department of Communication / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Harris Song Ao
- grid.437123.00000 0004 1794 8068Department of Communication / Institute of Collaborative Research / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Weixing Hu
- grid.437123.00000 0004 1794 8068Faculty of Social Sciences / Center for Research in Greater Bay Area, University of Macau, Macau, China
| | - Kaibin Xu
- grid.49470.3e0000 0001 2331 6153School of Journalism and Communication, Wuhan University, Wuhan, China
| | - Xinshu Zhao
- Department of Communication / Institute of Collaborative Research / Center for Research in Greater Bay Area, University of Macau, Macau, China. .,Department of Communication, Faculty of Social Sciences, University of Macau, Room 2051, E21B, Humanities and Social Sciences Building, Avenida da Universidade, Taipa, Macau, China.
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Almughthim AM, Jradi HA. Nutritional quality of prepackaged foods carrying health or nutritional claims in KSA. J Taibah Univ Med Sci 2022; 18:587-594. [PMID: 36818170 PMCID: PMC9906008 DOI: 10.1016/j.jtumed.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 11/06/2022] [Accepted: 12/03/2022] [Indexed: 12/23/2022] Open
Abstract
Objectives To evaluate the nutritional quality of products carrying health or nutritional claims to protect consumers from being misled and to ensure that they are provided with accurate information about food products that are associated with health or nutritional claims. Methods This was a cross-sectional survey of 1153 foods that were randomly sampled from 14 stores in Riyadh, KSA. The data were collected from nutritional facts presented on food labels and evaluated by comparing the mean level of nutrients between products that featured claims and those that did not use the UK nutrient profile model (UKNPM). Results Overall, 29% of products carried either health or nutritional claims. Only 19.2% of foods that carried health claims met Saudi Food and Drug Authority (SFDA) requirements, while 28.9% of all products that carried nutritional claims met SFDA criteria; however, the analysis indicated that products that carried health or nutritional claims were significantly lower in sugar (9.67 g/100 g), fat (9.2 g/100 g), saturated fat (3.2 g/100 g), and sodium (371.36 mg/100 g). According to the UKNPM, 46.9% of the products carrying claims were less healthy than those not carrying claims, and statistically significant differences were observed by product origin and category (p < 0.005 and p < 0.000, respectively). Conclusion The current representation of unregulated claims on food products may mislead the consumer. There is an urgent need for government legislation that limits their use except under certain conditions for the optimal protection of the population's health.
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Affiliation(s)
- Amal Mohammed Almughthim
- King Saud Bin Abdulaziz University for Health Science, Community and Environmental Health Department, Riyadh, KSA
- Corresponding address: King Saud Bin Abdulaziz University for Health Science, Riyadh, KSA.
| | - Hoda Ali Jradi
- King Saud Bin Abdulaziz University for Health Science, Department of Community and Environmental Health, College of Public Health and Health Informatics, Riyadh, KSA
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Mukanu MM, Delobelle P, Thow AM, Mchiza ZJR. Determinants of dietary patterns in school going adolescents in Urban Zambia. Front Nutr 2022; 9:956109. [PMID: 36091242 PMCID: PMC9452662 DOI: 10.3389/fnut.2022.956109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Understanding dietary patterns in a population is critical for decision making. This study aimed to identify the prevailing dietary patterns and their associated individual and school environment factors among school going adolescents in Lusaka, Zambia. Method A cross-sectional study involving 404 Grade 10 pupils from 10 secondary schools in Lusaka district was conducted. A 108-item unquantified Food Frequency Questionnaire (FFQ) was used to assess the learner's food intake practices. Principal component analysis (PCA) was used to derive dietary patterns from the 108 food items. In addition, a mapping of food vendors and types of food sold was conducted in the same 10 schools using a semi-structured observation checklist. Bivariate and multivariate multilevel regression was used to analyse the individual and school level determinants of the adolescent dietary patterns. Results The average age of learners was 16.1 years (SD 1.4 years); 234 (58%) were female while 170 (42%) male. “Snacking,” “vegetarian,” “health conscious,” and “traditional” dietary patterns accounting for 54.5% of variability in learner's diets were identified using PCA. At individual level, having weekly pocket money was significantly associated with snacking (p ≤ 0.0001). Self-identified poverty was associated with snacking (p ≤ 0.0001), vegetarian (p = 0.009) and traditional (p = 0.009) dietary patterns. School level factors like a school tuckshop (similar to canteen) that sells fast foods or a kantemba (semi-permanent makeshift store) within the school vicinity (p = 0.023) were significantly associated with a snacking dietary pattern. School tuckshop selling nshima (a thick maize based porridge) was significantly associated with vegetarian (p = 0.007), health conscious (p = 0.02) and traditional dietary patterns (p=0.01) while a tuckshop with fruit significantly predicted traditional (p ≤ 0.0001), vegetarian (p = 0.041), and snacking (p = 0.002), dietary patterns. Having a supermarket or fast food restaurants in the school vicinity did not significantly influence any dietary pattern. Conclusion Both individual behavioral and school environment level factors were found to be significant determinants of the four dietary patterns identified in this study.
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Affiliation(s)
- Mulenga Mary Mukanu
- School of Public Health, University of the Western Cape, Cape Town, South Africa
- *Correspondence: Mulenga Mary Mukanu
| | - Peter Delobelle
- Chronic Disease Initiative for Africa, University of Cape Town, Cape Town, South Africa
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, NSW, Australia
| | - Zandile June-Rose Mchiza
- School of Public Health, University of the Western Cape, Cape Town, South Africa
- Non-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
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Karolczak K, Guligowska A, Kostanek J, Soltysik B, Kostka T, Watala C. The amino acid content in the daily diet of seniors negatively correlates with the degree of platelet aggregation in a sex- and agonist-specific manner. Aging (Albany NY) 2022; 14:7240-7262. [PMID: 35985680 PMCID: PMC9550244 DOI: 10.18632/aging.204229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/27/2022] [Indexed: 11/25/2022]
Abstract
Aging is a significant risk factor for the development of thrombotic diseases, dependent on blood platelet reactivity. However, the risk of thrombosis also appears to be significantly modulated by dietary nutrient content. The aim of the current study was to assess the relationship between the amount of amino acids present in the daily diet (not supplemented) and the reactivity of blood platelets to arachidonate, collagen and ADP in 246 women and men aged 60–65 years. Platelet reactivity was tested using whole blood impedance aggregometry. Amino acid intake was assessed with a 24-hour Recall Questionnaire and calculated with Dieta 5.0 software. Older subjects receiving higher amounts of all essential amino acids with their daily diet exhibit significantly lower platelet responsiveness to AA-, COL- and ADP in a sex-specific manner: dietary amino acid content was more closely associated with AA- and, to some extent, ADP-induced platelet reactivity in women, and with COL-induced platelet aggregability in men. Therefore, dietary amino acid content may be a novel factor responsible for attenuating platelet reactivity in a sex- and agonist-specific manner.
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Affiliation(s)
- Kamil Karolczak
- Department of Haemostatic Disorders, Medical University of Lodz, Lodz, Poland
| | - Agnieszka Guligowska
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, Lodz, Poland
| | - Joanna Kostanek
- Department of Haemostatic Disorders, Medical University of Lodz, Lodz, Poland
| | - Bartlomiej Soltysik
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, Lodz, Poland
| | - Tomasz Kostka
- Department of Geriatrics, Healthy Aging Research Center (HARC), Medical University of Lodz, Lodz, Poland
| | - Cezary Watala
- Department of Haemostatic Disorders, Medical University of Lodz, Lodz, Poland
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Pang J, Chen K, Chen S, Chen X. Global burden of nonalcoholic steatohepatitis-related liver cancer, 1990-2019: a systematic analysis for the GBD 2019. Diabetol Metab Syndr 2022; 14:112. [PMID: 35941673 PMCID: PMC9361538 DOI: 10.1186/s13098-022-00885-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/01/2022] [Indexed: 12/03/2022] Open
Abstract
With the pandemic of metabolic diseases, nonalcoholic fatty liver disease (NAFLD) prevalence has dramatically elevated. NAFLD encompasses a spectrum of diseases including simple steatosis and nonalcoholic steatohepatitis (NASH), which can further progress to cirrhosis or liver cancer (LC). However, data are lacking on the burden and trend of NASH-related LC. Here, we analyzed the trends and changes of NASH-related LC burden using Global Burden of Disease (GBD) data (1990-2019). In 2019, the global incidence, prevalence, disability-adjusted life years (DALYs) and deaths of NASH related LC were 36.3 thousand (95% UI 29.5-44.9), 46.8 thousand (38.2-57.6), 796 thousand (657-976) and 34.7 thousand (28.4-43.2), respectively. The absolute numbers and rates of NASH-related LC incidence, mortality, and DALY significantly elevated from 1990 to 2019. With the age increased, the incidences, DALYs and deaths of NASH-related LC significantly elevated. The incidence and mortality rate of NASH-related LC significantly increased from 2010 to 2019 in individuals aged from 20 to 54 and older than 55 years old. We also found that a large disparity of NASH-related LC burden in different socio-demographic index (SDI) locations. The crude number and the age-standardized rate of incidences, DALYs and deaths was highest in the middle SDI locations and high SDI locations showed the largest increase of NASH-related LC burden from 1990 to 2019. Moreover, the proportion of LC incidences, deaths and DALYs attributed to NASH were 4.74%, 5.30% and 4.25%, respectively in 1990 which were increased by 43.5%, 35.3% and 49.4%, respectively in 2019. Conclusion: The global burden of NASH-related LC and the proportion LC burden attributed to NASH are significantly increasing.
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Affiliation(s)
- Juan Pang
- Department of Nutrition, School of Public Health, Sun Yat-Sen University (Northern Campus), No.74, 2nd Zhongshan Road, Guangzhou, People’s Republic of China 510080
| | - Ke Chen
- Department of Nutrition, School of Public Health, Sun Yat-Sen University (Northern Campus), No.74, 2nd Zhongshan Road, Guangzhou, People’s Republic of China 510080
| | - Shen Chen
- Department of Toxicology, School of Public Health, Sun Yat-Sen University (Northern Campus), No.74, 2nd Zhongshan Road, Guangzhou, People’s Republic of China 510080
| | - Xu Chen
- Department of Nutrition, School of Public Health, Sun Yat-Sen University (Northern Campus), No.74, 2nd Zhongshan Road, Guangzhou, People’s Republic of China 510080
- Department of Molecular, Cellular, and Developmental Biology, University of Colorado, Boulder, USA
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Nganabashaka JP, Ntawuyirushintege S, Niyibizi JB, Umwali G, Bavuma CM, Byiringiro JC, Rulisa S, Burns J, Rehfuess E, Young T, Tumusiime DK. Population-Level Interventions Targeting Risk Factors for Hypertension and Diabetes in Rwanda: A Situational Analysis. Front Public Health 2022; 10:882033. [PMID: 35844869 PMCID: PMC9283981 DOI: 10.3389/fpubh.2022.882033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/06/2022] [Indexed: 11/30/2022] Open
Abstract
Background Eighty percent (80%) of global Non-Communicable Diseases attributed deaths occur in low- and middle-income countries (LMIC) with hypertension and diabetes being key contributors. The overall prevalence of hypertension was 15.3% the national prevalence of diabetes in rural and urban was 7.5 and 9.7%, respectively among 15–64 years. Hypertension represents a leading cause of death (43%) among hospitalized patients at the University teaching hospital of Kigali. This study aimed to identify ongoing population-level interventions targeting risk factors for diabetes and hypertension and to explore perceived barriers and facilitators for their implementation in Rwanda. Methods This situational analysis comprised a desk review, key informant interviews, and stakeholders' consultation. Ongoing population-level interventions were identified through searches of government websites, complemented by one-on-one consultations with 60 individuals nominated by their respective organizations involved with prevention efforts. Semi-structured interviews with purposively selected key informants sought to identify perceived barriers and facilitators for the implementation of population-level interventions. A consultative workshop with stakeholders was organized to validate and consolidate the findings. Results We identified a range of policies in the areas of food and nutrition, physical activity promotion, and tobacco control. Supporting program and environment interventions were mainly awareness campaigns to improve knowledge, attitudes, and practices toward healthy eating, physical activity, and alcohol and tobacco use reduction, healthy food production, physical activity infrastructure, smoke-free areas, limits on tobacco production and bans on non-standardized alcohol production. Perceived barriers included limited stakeholder involvement, misbeliefs about ongoing interventions, insufficient funding, inconsistency in intervention implementation, weak policy enforcement, and conflicts between commercial and public health interests. Perceived facilitators were strengthened multi-sectoral collaboration and involvement in ongoing interventions, enhanced community awareness of ongoing interventions, special attention paid to the elderly, and increased funds for population-level interventions and policy enforcement. Conclusion There are many ongoing population-level interventions in Rwanda targeting risk factors for diabetes and hypertension. Identified gaps, perceived barriers, and facilitators provide a useful starting point for strengthening efforts to address the significant burden of disease attributable to diabetes and hypertension.
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Affiliation(s)
- Jean Pierre Nganabashaka
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- *Correspondence: Jean Pierre Nganabashaka
| | | | | | - Ghislaine Umwali
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Charlotte M. Bavuma
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Stephen Rulisa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Jacob Burns
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Taryn Young
- Centre for Evidence-Based Health Care, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - David K. Tumusiime
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Costa RM, Bezerra IWL, Torres KG, Pereira GS, de Souza AM, Oliveira AG. Participation in a food assistance program and excessive weight gain: an evaluation of the Brazilian Worker's Food Program in male and female manufacturing workers. BMC Public Health 2022; 22:1125. [PMID: 35658922 PMCID: PMC9167536 DOI: 10.1186/s12889-022-13447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background Several published studies have reported an association between participation in a food assistance program and greater prevalence of overweight/obesity. Our aim was to compare nutritional status and nutrient consumption between workers from manufacturing companies participant and non-participant in the Brazilian Workers’ Food Program (WFP). Design Cross-sectional survey, based on a probability sample of manufacturing workers in Brazil obtained by stratified two-stage sampling, comparative between WFP and non-WFP participating companies. Body mass index (BMI), waist circumference (WC), and nutrient consumption (24-hour recall) were collected by trained nutritionists. Statistical analysis was done separately in each sex with mixed effects multilevel linear regression model including sampling weights and covariate adjustment. Results Thirty-three companies were randomly selected from all companies in three different economic activity sectors (food and beverages, non-metallic minerals, and textiles) in North-eastern Brazil, with stratification by company size, and a random sample of 929 workers (484 from non-WFP and 445 from WFP companies) was obtained from those companies. In males, the WFP group had higher BMI (+ 1.08 kg/m2, p < 0.001), greater WC (+ 3.27 cm, p < 0.001) and greater prevalence of obesity (OR 1.67, p < 0.001). In females, no statistical significant differences were observed in anthropometric parameters, but the WFP group had lower prevalence of obesity (OR 0.49, p = 0.05). Among workers in companies that provide lunch, males from WFP companies have greater consumption of carbohydrates (+ 39.5 kcal, p = 0.02) and protein (+ 11.1 kcal, p = 0.08), while females have lower protein consumption (− 14.2 kcal, p = 0.04) and also lower total daily consumption of carbohydrates (− 59.3 Kcal, p = 0.05) and total lipids (− 14.2 Kcal, p = 0.04). Conclusions Participation in the WFP is associated with increased BMI and WC among male workers; however, this association was not found in females. Compared to the non-WFP group, in the WFP group, males have greater consumption of carbohydrates and protein at lunch, while women have lower protein intake. These results indicate the need that proposals for public policies aimed to the improvement of the nutritional status of populations take into consideration the different effects of food assistance programs in males and females. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13447-8.
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Affiliation(s)
- Raiane Medeiros Costa
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil
| | - Ingrid Wilza Leal Bezerra
- Nutrition Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, s/n, Lagoa Nova, Natal, RN, 59078-970, Brazil.
| | - Karina Gomes Torres
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil
| | - Gabriela Santana Pereira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil
| | - Anissa Melo de Souza
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil
| | - Antonio Gouveia Oliveira
- Postgraduate Program in Health Sciences, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil.,Pharmacy Department, Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Av. Nilo Peçanha 620, Petrópolis, Natal, RN, 59012-300, Brazil
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Djojosoeparto SK, Kamphuis CBM, Vandevijvere S, Poelman MP. How can National Government Policies Improve Food Environments in the Netherlands? Int J Public Health 2022; 67:1604115. [PMID: 35321050 PMCID: PMC8935556 DOI: 10.3389/ijph.2022.1604115] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 01/21/2022] [Indexed: 01/15/2023] Open
Abstract
Objectives: Government policies are essential to create food environments that support healthy diets. The aims of this study were 1) to benchmark the implementation of Dutch government policies influencing food environments, and 2) to identify and prioritize actions to improve food environments in the Netherlands. Methods: The Healthy Food Environment Policy Index (Food-EPI) was applied. The Food-EPI includes 46 indicators of food environment policy and infrastructure support. Independent experts (n = 28) rated the extent of implementation on these indicators against international best practices, and formulated and prioritized policy and infrastructure support actions to improve food environments. Results: Most policy indicators were rated as having a low (50%) or very low (41%) level of implementation. Most infrastructure support indicators were rated as having a fair (42%) or medium (42%) level of implementation. 18 policy and 11 infrastructure support actions were recommended by experts to improve food environments in the Netherlands. Conclusion: There is large potential for the Dutch national government to strengthen its policy action and infrastructure support in order to improve the healthiness of food environments in the Netherlands.
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Affiliation(s)
- Sanne K. Djojosoeparto
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, Netherlands
- *Correspondence: Sanne K. Djojosoeparto,
| | - Carlijn B. M. Kamphuis
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, Netherlands
| | | | - Maartje P. Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, Wageningen, Netherlands
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Xu C, Cao Z, Yang H, Hou Y, Wang X, Wang Y. Association Between the EAT-Lancet Diet Pattern and Risk of Type 2 Diabetes: A Prospective Cohort Study. Front Nutr 2022; 8:784018. [PMID: 35096931 PMCID: PMC8795697 DOI: 10.3389/fnut.2021.784018] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 12/01/2021] [Indexed: 12/11/2022] Open
Abstract
Background: The EAT-Lancet Commission has promulgated a sustainable dietary guideline and recommended that it was designed to improve the human health and support environmental sustainability. Objective: This research was designed to explore the association between this healthy diet pattern (EAT-Lancet diet pattern, EAT-LDP) and risk of type 2 diabetes (T2D). Methods: Between 2006 and 2010, a total of 59,849 participants from the UK Biobank without diabetes, cardiovascular disease, or cancers were included at baseline. The EAT-LDP score was constructed on the sum of 14 food components and then categorized into three tertiles. Multivariable Cox proportional hazards regression models were conducted to explore the association between EAT-LDP score and the risk of incident T2D. A mediation analysis was also implemented to disentangle the role of body mass index (BMI) and waist circumference in the relationship between EAT-LDP score and T2D. Results: During a median follow-up of 10 years, 2,461 incident T2D cases were recorded. In analyses that compared tertile 3 of the EAT-LDP score (highest) with tertile 1 (lowest), the hazard ratio (HR) for T2D was 0.81 (95% CI: 0.72–0.90) after adjusting for sociodemographic status and health-related factors. Participants who reported a one-point increase in the diet score were associated with a 6% decrease in risk of T2D (HR: 0.94, 95% CI: 0.91–0.97). A significant indirect association was observed between the EAT-LDP score and T2D (β: 0.66, 95% CI: 0.65–0.67), indicating that 44% of the association of EAT-LDP score with T2D was mediated by BMI. Additionally, 40% of the association of EAT-LDP score with T2D was mediated by waist circumference was also observed. Conclusions: Our findings indicate that a higher adherence to EAT-LDP contributes to lower risk of T2D. Further independent validation is needed to be conducted before applying the EAT-LDP to inform dietary guidelines.
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Affiliation(s)
- Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhi Cao
- Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Yabing Hou
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaohe Wang
- School of Public Health, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Xiaohe Wang
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- Yaogang Wang
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15
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Dorner TE, Lackinger C, Haider S, Stein KV. Lifestyle Parameters in Patients with Diabetes Mellitus and in the General Adult Population-Trends over Five Years: Results of the Austrian National Health Interview Series. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189910. [PMID: 34574833 PMCID: PMC8467903 DOI: 10.3390/ijerph18189910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/14/2021] [Accepted: 09/16/2021] [Indexed: 12/26/2022]
Abstract
Background: Not smoking, performing >150 min of aerobic physical activity (PA) and muscle strengthening exercises/week, and consuming >5 portions of fruit and vegetables/day are lifestyle recommendations for both the general population and people with diabetes mellitus (DM). Methods: A total of 15,771 and 15,461 persons from the Austrian Health Interview Surveys 2014 and 2019, respectively, including 4.9% and 6.0% of people with DM, were analysed in terms of their smoking, PA, and nutritional behaviours. Logistic regression models were performed for the lifestyle factors, adjusted for socio-demographic and health-related factors. Adjusted interactions between the survey year and DM on the lifestyle factors were computed. Results: The proportions of smokers were 23.9% and 20.2%, of people complying with the PA recommendations were 24.9% and 21.4%, and with fruit and vegetables recommendations were 7.1% and 5.5%, respectively, with significantly lower proportions of smokers and persons complying with the PA recommendations among people with DM. The fully adjusted odds ratios (95% confidence interval) for people with DM were 1.09 (0.94–1.26), 1.44 (1.23–1.69), and 0.90 (0.71–1.13) for smoking, not complying with PA recommendations, and not complying with fruit and vegetables recommendations, respectively. The proportion of people complying with PA recommendations decreased to a greater extent (p < 0.001) in people with DM (16.5% to 8.3%) compared to people without DM (25.3% to 22.3%). Conclusion: Diabetogenic lifestyle behaviours increased in the general Austrian population in recent years, which was especially true for people with DM regarding PA.
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Affiliation(s)
- Thomas Ernst Dorner
- Social Insurance Fund for Public Service, Railway and Mining Industries, 1080 Vienna, Austria; (T.E.D.); (C.L.)
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
| | - Christian Lackinger
- Social Insurance Fund for Public Service, Railway and Mining Industries, 1080 Vienna, Austria; (T.E.D.); (C.L.)
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
| | - Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria;
| | - Katharina Viktoria Stein
- Social Insurance Fund for Public Service, Railway and Mining Industries, 1080 Vienna, Austria; (T.E.D.); (C.L.)
- Karl-Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
- Correspondence:
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Effectiveness of food environment policies in improving population diets: a review of systematic reviews. Eur J Clin Nutr 2021; 76:637-646. [PMID: 34545213 DOI: 10.1038/s41430-021-01008-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/11/2021] [Accepted: 09/03/2021] [Indexed: 11/09/2022]
Abstract
Unhealthy population diets contribute to the burden of non-communicable diseases. Policies targeting food environments (FE policies) may improve population diets. This review of systematic reviews aims to summarise recent evidence of the effectiveness of FE policies in improving diets. We searched PubMed for systematic reviews published from January 2010 onwards. Eligible FE policies included: nutrition and food labelling, provision of foods in public institutions or specific settings, price, marketing, nutrition quality and portion size, and availability of foods in retail and food service establishments. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) instrument was used to assess review quality. Reviews of critically low quality were excluded. Results were narratively reported in text and tables. The search identified 1102 records after removing duplicates. Following screening and quality assessment we included 12 systematic reviews. Two reviews focused on nutrition and food labelling, two on provision of foods in school settings, four on price, none on marketing policies, three on nutrition quality and portion size and one on the availability of foods in retail and food service establishments. Pricing policies (tax/subsidy) appear effective in altering intake and purchase of targeted foods and beverages. FE policies targeting the availability of foods in retail and food establishments, food provision in school settings, product reformulation and the size of portions/packages or items of tableware also appear effective. Overall, policies targeting food environments appear effective in improving population diets. However, there is a need for further high-quality evidence.
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Association between Food Preferences and Food Habits in a Polish Adolescents' COVID-19 Experience (PLACE-19) Study. Nutrients 2021; 13:nu13093003. [PMID: 34578881 PMCID: PMC8471474 DOI: 10.3390/nu13093003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 11/16/2022] Open
Abstract
Food preferences are among the most influential factors of food habits in the vulnerable period of adolescence; in addition, gender-dependent differences in food preferences are also observed. The aim of the present study was to analyze differences in food habits between individuals stratified based on their food preferences in a population-based sample of adolescents aged 15–20. The study was conducted within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population in a group of 2419 secondary school students who were randomly chosen to participate in the study using a random quota sampling procedure. The food preferences were determined on the basis of a validated Food Preference Questionnaire (FPQ) (which enables assessing preference of vegetables, fruit, meat/fish, dairy, snacks, and starches), whereas food habits were determined on the basis of the Adolescents’ Food Habits Checklist (AFHC) (which enables assessing food purchase, preparation, and consumption habits). The analysis involved three homogenous clusters (‘low-preferring’, ‘hedonists’, and ‘high-preferring’), which were identified using the k-means algorithm. It was found that for a number of the assessed food purchase, preparation, and consumption habits, there were statistically significant differences between the ‘low-preferring’, ‘hedonists’, and ‘high-preferring’ clusters. Within food purchase habits, the food preference influenced frequency of buying pastries/cakes and frequency of eating takeaway meals for all the respondents, while for female respondents, it influenced also choice of desserts in restaurants, and for male respondents, it influenced choosing a low-fat lunch away from home (p < 0.05). Within food preparation habits, the food preference influenced the fat content in desserts at home, the frequency of eating at least one serving of vegetables/salad with an evening meal, the frequency of spreading butter/margarine on bread thinly, and the frequency of having cream on desserts for all the respondents; meanwhile, for female respondents, it also influenced the frequency of avoiding fried foods and the frequency of including chocolate/biscuits in their packed lunch (p < 0.05). Within food consumption habits, the food preference influenced the frequency of eating a dessert/pudding, eating at least one serving of fruit a day, eating at least one serving of vegetables/salad a day, avoiding sausages/burgers, trying to ensure they eat plenty of fruit and vegetables, and frequency of choosing fruit as a snack for all the respondents; meanwhile, for male respondents, it also influenced the frequency of eating sweet snacks and eating at least three servings of fruit most days (p < 0.05). Taking into account that some improper food habits may be typical for the specific clusters, there is an urgent need to analyze and address them for the purposes of public health and to bear in mind that some of those habits are gender-dependent.
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Diet Quality According to Mental Status and Associated Factors during Adulthood in Spain. Nutrients 2021; 13:nu13051727. [PMID: 34069704 PMCID: PMC8160880 DOI: 10.3390/nu13051727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 05/03/2021] [Accepted: 05/17/2021] [Indexed: 12/14/2022] Open
Abstract
Common mental disorders (CMD) are characterized by non-psychotic depressive symptoms, anxiety and somatic complaints, which affect the performance of daily activities. This study aimed to analyze prevalence of diet quality among adults with and without CMD from 2006 to 2017, to study the frequency of food consumption and diet quality according to mental status and age, and to determine which sociodemographic, lifestyle and health-related factors are associated with poor/moderate diet quality, according to mental status. A nationwide cross-sectional study was performed in adults with (n = 12,545) and without CMD (n = 48,079). The data were obtained from three Spanish National Health Surveys (2006, 2011/2012 and 2017). Two logistic regression analyses were used to identify factors associated with diet quality in people with and without CMD. Among those with CMD, the probability of having poor/moderate diet quality was significantly lower for overweight or obese people and those who took part in leisure-time physical activity. Among those without CMD, university graduates were less likely to have a poor/moderate diet quality. Good diet quality was observed more in older adults (≥65 years old) than in emerging (18–24 years old) or young adults (25–44 years old), regardless of mental status.
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Nutrient profile models a useful tool to facilitate healthier food choices: A comprehensive review. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.01.082] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Acton RB, Kirkpatrick SI, Hammond D. Exploring the main and moderating effects of individual-level characteristics on consumer responses to sugar taxes and front-of-pack nutrition labels in an experimental marketplace. Canadian Journal of Public Health 2021; 112:647-662. [PMID: 33768507 DOI: 10.17269/s41997-021-00475-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 01/11/2021] [Indexed: 01/01/2023]
Abstract
INTERVENTION This study examined whether the impacts of sugar taxes and front-of-pack (FOP) nutrition labels differ across socio-demographic subgroups. RESEARCH QUESTION What are the main and moderating effects of individual-level characteristics on the nutrient content of participants' purchases in response to varying taxation levels and FOP labels? METHODS Data from an experimental marketplace were analyzed. A sample of 3584 Canadians aged 13 years and older received $5 to purchase an item from a selection of 20 beverages and 20 snack foods. Participants were shown products with one of five FOP labels and completed eight within-subject purchasing tasks with different tax conditions. Linear mixed models were used to estimate the main and moderating effects of 11 individual-level variables on the sugars, sodium, saturated fats, and calorie content of participants' purchases. RESULTS Participants who were younger, male, and more frequent consumers of sugary drinks purchased products containing more sugars, sodium, saturated fats, and calories. Sex and age moderated the relationship between tax condition and sugars or calories purchased: female participants were more responsive than males to a tax that included fruit juice, and younger participants were more responsive to all sugar tax conditions than older participants. Reported thirst and education level also moderated the relationship between tax condition and calories purchased. No individual-level characteristics moderated the effects of FOP labels. CONCLUSION A small proportion (7 of 176) of the moderating effects tested in this study were significant. Sugar taxes and FOP labelling policies may therefore produce similar effects across key socio-demographic groups.
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Affiliation(s)
- Rachel B Acton
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W., Waterloo, ON, N2L 3G1, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W., Waterloo, ON, N2L 3G1, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W., Waterloo, ON, N2L 3G1, Canada.
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The associations between orthorexia nervosa and the sociocultural attitudes: the mediating role of basic psychological needs and health anxiety. Eat Weight Disord 2021; 26:125-134. [PMID: 31811515 DOI: 10.1007/s40519-019-00826-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 11/30/2019] [Indexed: 02/03/2023] Open
Abstract
PURPOSE Given the range of negative correlates associated with orthorexia nervosa (ON), it is important to identify factors that might contribute to the elevated ON tendencies. Based on the tripartite model of influence, we tested whether sociocultural attitudes towards appearance (i.e., thin and muscular internalization as well as family, peer and media pressure) could contribute to ON. We hypothesized that these attitudes could exert their effect through the intervening processes basic psychological need fulfillment and health anxiety. METHODS The hypotheses were tested on a sample of 710 young adults (Mage = 21.79, SDage = 2.31). Participants completed validated questionnaires measuring the constructs of interest. RESULTS According to the structural equation modeling results, ON was predicted by thinness and muscular internalization as well as media pressure. Need fulfillment and health anxiety partially mediated these relationships. Family and peer pressure were not related to ON. DISCUSSION The present results suggest that internalization of appearance ideas and media pressure contribute to ON through need fulfillment and health anxiety. These findings also provide novel insight into the nature of ON. LEVEL OF EVIDENCE Level V (descriptive cross-sectional study.
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22
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Development and validation of a meal quality index with applications to NHANES 2005-2014. PLoS One 2020; 15:e0244391. [PMID: 33351843 PMCID: PMC7755194 DOI: 10.1371/journal.pone.0244391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/09/2020] [Indexed: 11/19/2022] Open
Abstract
The Meal Balance Index (MBI) assesses the nutritional quality and balance of meals. It is a score between 0 and 100 that takes into account both shortfall and excess nutrients, adjusted for the energy content of the meal. In the present study the score was applied to 147849 meals reported in the National Health and Nutrition Examination Surveys (NHANES) 2005-2014 in order to evaluate its validity and compare against exemplary meals designed as part of 24h diets that meet US dietary guidelines. Meals from exemplary menu plans developed by nutrition experts scored on average 76±14 (mean ± standard deviation) whereas those of NHANES participants scored 45±14. Scores of breakfast, lunch, dinner, snack, considered jointly as independent variables, were moderately but positively and significantly associated with the Healthy Eating Index (Pearson correlation 0.6). MBI scores were significantly associated with the density of positive micronutrients (e.g. Vit A, Vit C) and favorable food groups (e.g. fruits, whole grains) not directly included in the MBI algorithm. The MBI is a valid tool to assess the nutritional quality of meals reported in the US population and if applied to culinary recipe websites could potentially help users to understand which meals are nutritionally balanced. Choice of more balanced individual meals can guide healthier cooking and eating.
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Campos D, Escudero-Marín M, Snitman CM, Torres-Espínola FJ, Azaryah H, Catena A, Campoy C. The Nutritional Profile of Food Advertising for School-Aged Children via Television: A Longitudinal Approach. CHILDREN-BASEL 2020; 7:children7110230. [PMID: 33212760 PMCID: PMC7698276 DOI: 10.3390/children7110230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022]
Abstract
The prevalence of childhood obesity continues to increase. Screen time, one of the most documented reasons for the obesogenic environment, enhances childhood obesity, since advertisements for unhealthy food products are still broadcast on channels for children. This is presently one of the main challenges for the government in Spain, since the current laws and obligations are not updated. This study aims to analyze food advertising aimed at children on Spanish television in 2013 and 2018 on children's and general channels to test the effect of laws and obligations over time. In total, we viewed 512 h of the most viewed channels, two children's and two general channels, during the week and on weekends during specific periods of 2013 and 2018. Food advertising was categorized as core, non-core, and other food advertisement (CFA, NCFA, and OFA, respectively) according to the nutritional profile. A total of 2935 adverts were analyzed, 1263 in 2013 and 1672 in 2018. A higher proportion of NCFAs were broadcast on children's channels than in prior years, rising from 52.2% to 69.8% (p < 0.001). Nowadays, the risk of watching NCFAs on children's channels compared to general channels turns out to be higher (Odds ratio > 2.5; p < 0.001), due to exposure to adverts for high-sugar and high-fat foods such as cakes, muffins, cookies, and fried and frozen meals rich in fat. In conclusion, the trends of nutritional profiles in food advertising on television are worsening over time, since the prevalence of NCFAs was higher in 2018 than in 2013. Currently, CFAs are not mainly broadcast on children's channels, confirming high-risk exposure to non-core food advertising by watching them. Thus, food advertising laws and obligations should be adapted to increase compliance.
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Affiliation(s)
- Daniel Campos
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (M.E.-M.); (F.J.T.-E.); (H.A.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
- Correspondence: (D.C.); (C.C.); Tel.: +34-678-725-790 (D.C.); +34-607-631-601 (C.C.)
| | - Mireia Escudero-Marín
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (M.E.-M.); (F.J.T.-E.); (H.A.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
| | - Camila M. Snitman
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
| | - Francisco J. Torres-Espínola
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (M.E.-M.); (F.J.T.-E.); (H.A.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
| | - Hatim Azaryah
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (M.E.-M.); (F.J.T.-E.); (H.A.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
| | - Andrés Catena
- Mind, Brain and Behaviour International Research Centre (CIMCYC), University of Granada, 18011 Granada, Spain;
| | - Cristina Campoy
- Department of Paediatrics, School of Medicine, University of Granada, Avda. Investigación 11, 18016 Granada, Spain; (M.E.-M.); (F.J.T.-E.); (H.A.)
- EURISTIKOS Excellence Centre for Paediatric Research, Biomedical Research Centre, University of Granada, 18016 Granada, Spain;
- Instituto de Investigación Biosanitaria de Granada (Ibs-GRANADA), Health Sciences Technological Park, 18012 Granada, Spain
- Spanish Network of Biomedical Research in Epidemiology and Public Health (CIBERESP), Granada’s Node, Institute of Health Carlos III, 28029 Madrid, Spain
- Correspondence: (D.C.); (C.C.); Tel.: +34-678-725-790 (D.C.); +34-607-631-601 (C.C.)
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Qualls-Creekmore E, Marlatt KL, Aarts E, Bruce-Keller A, Church TS, Clément K, Fisher JO, Gordon-Larsen P, Morrison CD, Raybould HE, Ryan DH, Schauer PR, Spector AC, Spetter MS, Stuber GD, Berthoud HR, Ravussin E. What Should I Eat and Why? The Environmental, Genetic, and Behavioral Determinants of Food Choice: Summary from a Pennington Scientific Symposium. Obesity (Silver Spring) 2020; 28:1386-1396. [PMID: 32520444 PMCID: PMC7501251 DOI: 10.1002/oby.22806] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/29/2020] [Accepted: 03/09/2020] [Indexed: 12/17/2022]
Abstract
This review details the proceedings of a Pennington Biomedical scientific symposium titled, "What Should I Eat and Why? The Environmental, Genetic, and Behavioral Determinants of Food Choice." The symposium was designed to review the literature about energy homeostasis, particularly related to food choice and feeding behaviors, from psychology to physiology. This review discusses the intrinsic determinants of food choice, including biological mechanisms (genetics), peripheral and central signals, brain correlates, and the potential role of the microbiome. This review also address the extrinsic determinants (environment) of food choice within our physical and social environments. Finally, this review reports the current treatment practices for the clinical management of eating-induced overweight and obesity. An improved understanding of these determinants will inform best practices for the clinical treatment and prevention of obesity. Strategies paired with systemic shifts in our public health policies and changes in our "obesogenic" environment will be most effective at attenuating the obesity epidemic.
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Affiliation(s)
- Emily Qualls-Creekmore
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Kara L. Marlatt
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Esther Aarts
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Annadora Bruce-Keller
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Tim S. Church
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
- ACAP Health, Dallas, TX, USA
| | - Karine Clément
- Sorbonne Université, INSERM, Nutrition and Obesity: Systemic Approaches (NutriOmics) Research Unit, Paris, France
- Assistance Publique Hôpitaux de Paris, Nutrition e, Pitié-Salpêtrière Hospital, 47-83 bd de l’Hôpital, Paris, France
| | - Jennifer O. Fisher
- Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Christopher D. Morrison
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Helen E. Raybould
- Department of Anatomy, Physiology, Cell Biology, UC Davis School of Veterinary Medicine, Davis, CA, USA
| | - Donna H. Ryan
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Philip R. Schauer
- Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Alan C. Spector
- Department of Psychology and Program in Neuroscience, Florida State University, Tallahassee, FL, USA
| | - Maartje S. Spetter
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Germany; School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Garret D. Stuber
- Departments of Anesthesiology, Pain Medicine & Pharmacology, University of Washington, Seattle, WA, USA
| | - Hans-Rudolf Berthoud
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
| | - Eric Ravussin
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA, USA
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Marcone MF, Madan P, Grodzinski B. An Overview of the Sociological and Environmental Factors Influencing Eating Food Behavior in Canada. Front Nutr 2020; 7:77. [PMID: 32582753 PMCID: PMC7283517 DOI: 10.3389/fnut.2020.00077] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/04/2020] [Indexed: 11/23/2022] Open
Abstract
This review extensively discusses various socio environmental factors affecting eating behavior of the general public within Canada including the development and implementation of national policies. A framework representing the determinants of healthy eating can be grouped into four categories i.e., the individual determinants, the economic environment, the social environment and the physical environment. This framework allowed for addressing food insecurity and social economic ecosystem of Canadians. Lastly, we investigate the role in which biotechnology plays in improving food security and addresses the significant impact biotechnology has contributed toward on agriculture and the food market. Overall, this review using such sources as Web of Science, Pub Med and Scopus provides significant contribution toward understanding the social economic environment and eating behavior of people living in Canada. In conclusion, this has led to identify a research gap as there is a significant need to address the development and implementation of policies in the food and nutrition environment.
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Affiliation(s)
- Massimo F Marcone
- Department of Food Science, University of Guelph, Guelph, ON, Canada
| | - Pavneesh Madan
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Wong MCS, Huang J, Wang J, Chan PSF, Lok V, Chen X, Leung C, Wang HHX, Lao XQ, Zheng ZJ. Global, regional and time-trend prevalence of central obesity: a systematic review and meta-analysis of 13.2 million subjects. Eur J Epidemiol 2020; 35:673-683. [PMID: 32448986 PMCID: PMC7387368 DOI: 10.1007/s10654-020-00650-3] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 05/18/2020] [Indexed: 01/01/2023]
Abstract
We aimed to examine the global prevalences of central obesity according to age, sex, race, place of residence, geographical region, national income level, and the definitions of central obesity. MEDLINE and Embase were searched. Studies with sample size of ≥ 500 and investigated individuals aged ≥ 15 years were included. Metaprop (a Stata command) was adopted to conduct a meta-analysis of prevalence, and the Freeman-Tukey Double Arcsine Transformation was used to stabilize the variances. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of central obesity. There were 288 studies involving 13,233,675 individuals in this analysis. The overall prevalence of central obesity was 41.5% (95% CI 39.9–43.2%). A higher prevalence was found in older individuals, female subjects, urban residents, Caucasians, and populations of higher income level countries. Regarding regional variations, the highest prevalence was found in Sothern America (55.1%, 95% CI 45.8–64.3%) and Central American (52.9%, 95% CI 32.7–72.7%). Its prevalence was rapidly rising from 1985 to 2014. From 1985–1999 to 2010–2014, younger subjects aged 15–40 years showed a more drastic rise in prevalence (16.3 to 33.9%) than subjects aged > 40 years (43.6 to 57.9%). Male individuals have a more drastic rise (25.3 to 41.6%) than females (38.6 to 49.7%). Major increasing in prevalence of the condition in the past three decades, particularly in certain subgroups. These findings could act as a useful reference to inform public health strategies to minimize the impact of central obesity on population health.
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Affiliation(s)
- Martin C. S. Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Junjie Huang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Jingxuan Wang
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Paul S. F. Chan
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Veeleah Lok
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Xiao Chen
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Colette Leung
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, 4/F, School of Public Health, Prince of Wales Hospital, Hong Kong, Hong Kong
| | - Zhi-Jie Zheng
- Department of Global Health, School of Public Health, Peking University, 38, Xue Yuan Road, Haidian District, Beijing, China
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Ali OG, Ghanem AN, Ustun B. Estimating the potential impact of behavioral public health interventions nationally while maintaining agreement with global patterns on relative risks. PLoS One 2020; 15:e0232951. [PMID: 32401782 PMCID: PMC7219750 DOI: 10.1371/journal.pone.0232951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/24/2020] [Indexed: 11/23/2022] Open
Abstract
Objective This paper introduces a novel method to evaluate the local impact of behavioral scenarios on disease prevalence and burden with representative individual level data while ensuring that the model is in agreement with the qualitative patterns of global relative risk (RR) estimates. The method is used to estimate the impact of behavioral scenarios on the burden of disease due to ischemic heart disease (IHD) and diabetes in the Turkish adult population. Methods Disease specific Hierarchical Bayes (HB) models estimate the individual disease probability as a function of behaviors, demographics, socio-economics and other controls, where constraints are specified based on the global RR estimates. The simulator combines the counterfactual disease probability estimates with disability adjusted life year (DALY)-per-prevalent-case estimates and rolls up to the targeted population level, thus reflecting the local joint distribution of exposures. The Global Burden of Disease (GBD) 2016 study meta-analysis results guide the analysis of the Turkish National Health Surveys (2008 to 2016) that contain more than 90 thousand observations. Findings The proposed Qualitative Informative HB models do not sacrifice predictive accuracy versus benchmarks (logistic regression and HB models with non-informative and numerical informative priors) while agreeing with the global patterns. In the Turkish adult population, Increasing Physical Activity reduces the DALYs substantially for both IHD by 8.6% (6.4% 11.2%), and Diabetes by 8.1% (5.8% 10.6%), (90% uncertainty intervals). Eliminating Smoking and Second-hand Smoke predominantly decreases the IHD burden 13.1% (10.4% 15.8%) versus Diabetes 2.8% (1.1% 4.6%). Increasing Fruit and Vegetable Consumption, on the other hand, reduces IHD DALYs by 4.1% (2.8% 5.4%) while not improving the Diabetes burden 0.1% (0% 0.1%). Conclusion While the national RR estimates are in qualitative agreement with the global patterns, the scenario impact estimates are markedly different than the attributable risk estimates from the GBD analysis and allow evaluation of practical scenarios with multiple behaviors.
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Affiliation(s)
- Ozden Gur Ali
- College of Administrative Sciences and Economics, Koc University, Istanbul, Turkey
- * E-mail: ,
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28
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Fuster M, Guerrero K, Elbel B, Ray K, Huang TTK. Engaging Ethnic Restaurants to Improve Community Nutrition Environments: A Qualitative Study with Hispanic Caribbean Restaurants in New York City. Ecol Food Nutr 2020; 59:294-310. [PMID: 31964188 DOI: 10.1080/03670244.2020.1717481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study used interviews with New York City Hispanic Caribbean (HC) restaurant owners, managers, and cooks/chefs (n=19) to examine perceptions concerning the healthfulness of the HC diet and diet-related disparities in the HC community, and document factors potentially influencing their engagement in community nutrition interventions. The interviews revealed high awareness of diet-related issues. Respondents had mixed notions concerning their role in improving community food environments, noting important barriers for collaboration to consider in future interventions. The study underscores the important role of ethnic restaurants, providing information to facilitate engagement with this largely untapped sector in immigrant/ethnic communities in the US.
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Affiliation(s)
- Melissa Fuster
- Department of Health and Nutrition Science, Brooklyn College, City University of New York , Brooklyn, USA
| | - Kevin Guerrero
- Department of Health and Nutrition Science, Brooklyn College, City University of New York , Brooklyn, USA
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine , New York, USA.,Wagner Graduate School of Public Service, New York University , New York, USA
| | - Krishnendu Ray
- Department of Nutrition and Food Studies, New York University, Steinhardt School of Culture, Education, and Human Development , New York, USA
| | - Terry T-K Huang
- Department of Community Health and Social Sciences and Center for Systems and Community Design, City University of New York Graduate School of Public Health and Health Policy , New York, USA
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Akaichi F, Revoredo Giha C, Glenk K, Gil JM. How Consumers in the UK and Spain Value the Coexistence of the Claims Low Fat, Local, Organic and Low Greenhouse Gas Emissions. Nutrients 2020; 12:E120. [PMID: 31906308 PMCID: PMC7019742 DOI: 10.3390/nu12010120] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/11/2019] [Accepted: 12/11/2019] [Indexed: 01/22/2023] Open
Abstract
This study investigates the substitution and complementary effects for beef mince attributes drawing on data from large choice experiments conducted in the UK and Spain. In both countries, consumers were found to be willing to pay a price premium for the individual use of the labels "Low Fat" (UK: €3.41, Spain: €1.94), "Moderate Fat" (UK: €2.23, Spain: €1.57), "Local" (UK: €1.54, Spain: €1.61), "National" (UK: €1.33, Spain: €1.37), "Organic" (UK: €1.02, Spain: €1.09) and "Low Greenhouse Gas Emissions (GHG)" (UK: €2.05, Spain: €0.96). The results showed that consumers in both countries do not treat desirable food attributes as unrelated. In particular, consumers in Spain are willing to pay a price premium for the use of the labels "Local", "Organic" and "Low GHG" on beef mince that is also labelled as having low or moderate fat content. By contrast, consumers in the UK were found to discount the coexistence of the labels "Low Fat" and "Organic", "Low Fat" and "Low GHG" and "Moderate Fat" and "Low GHG". The results, however, suggest that in the UK the demand for beef mince with moderate (low) fat content can be increased if it is also labelled as "Organic" or "Low GHG" ("Local").
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Affiliation(s)
- Faical Akaichi
- Department of Rural Economy, Environment and Society, Scotland’s Rural College, Edinburgh EH9 3JG, UK; (C.R.G.); (K.G.)
| | - Cesar Revoredo Giha
- Department of Rural Economy, Environment and Society, Scotland’s Rural College, Edinburgh EH9 3JG, UK; (C.R.G.); (K.G.)
| | - Klaus Glenk
- Department of Rural Economy, Environment and Society, Scotland’s Rural College, Edinburgh EH9 3JG, UK; (C.R.G.); (K.G.)
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Vargas-Meza J, Jáuregui A, Contreras-Manzano A, Nieto C, Barquera S. Acceptability and understanding of front-of-pack nutritional labels: an experimental study in Mexican consumers. BMC Public Health 2019; 19:1751. [PMID: 31888575 PMCID: PMC6938009 DOI: 10.1186/s12889-019-8108-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/18/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Front-of-package labelling is a cost-effective strategy to help consumers make healthier choices and informed food purchases. The effect of labels is mediated by consumer understanding and acceptability of the label. We compared the acceptability and understanding of labels used in Latin-America among low- and middle-income Mexican adults. METHODS Participants (n = 2105) were randomly assigned to one of three labels: Mexican Guideline Daily Allowances (GDA), Ecuador's Multiple Traffic Lights (MTL), or Chile's Warning Labels (WL) in red. Label acceptability was evaluated through items regarding likeability, attractiveness and perceived cognitive workload. Objective understanding was evaluated by asking participants to select the product with the lowest nutritional quality among three products. We measured the time participants took to choose the product. Differences in label acceptability, understanding and time required to choose a product across labels were tested. RESULTS Compared to the GDA, a higher proportion of participants liked the MTL and WL, considered them attractive, and with a lower perceived cognitive workload (p < 0.05). Participants had 4.00 (2.86-5.59) times the odds of correctly identifying the product with the lowest nutritional quality when using the MTL label and 4.52 (3.24-6.29) times the odds when using the WL, in comparison to the GDA. Time required to choose the product was lower for the MTL (Median: 11.25 s; IQR = 8.00-16.09) and the WL (Median = 11.94 s, IQR = 8.56-16.52) compared to the GDA (Median: 15.31 s; IQR = 10.81-20.21; p < 0.05). No differences were observed between the MTL and the WL. CONCLUSIONS GDA had the lowest acceptability and understanding among the labels tested. The MTL and the WL were more accepted and understood, and allowed low- and middle-income consumers to make nutrition-quality related decisions more quickly. WL or MTL may foster healthier food choices in the most vulnerable groups in Mexico compared to the current labelling format.
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Affiliation(s)
- Jorge Vargas-Meza
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Alejandra Jáuregui
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | | | - Claudia Nieto
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Simón Barquera
- Center for Nutrition and Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
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Vik FN, Van Lippevelde W, Øverby NC. Free school meals as an approach to reduce health inequalities among 10-12- year-old Norwegian children. BMC Public Health 2019; 19:951. [PMID: 31311509 PMCID: PMC6632183 DOI: 10.1186/s12889-019-7286-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/09/2019] [Indexed: 12/23/2022] Open
Abstract
Background Children spend a considerable amount of time at school and consume at least one meal/day. This study aimed to investigate if a free, healthy school meal every day for one school year was associated with children’s intake of healthy foods at school, weight status and moderating effects of socio-economic status. Methods A non-randomized study design with an intervention and a control group was used to measure change in children’s dietary habits at lunchtime. In total, 164 children participated; 55 in the intervention group and 109 in the control group (baseline). Intervention-children were served a free, healthy school meal every school day for one year. Participating children completed a food frequency questionnaire at baseline, at five months follow-up and after one year. Children’s anthropometrics were measured at all three timepoints. Intervention effects on children’s Healthy food score, BMI z-scores, and waist circumference were examined by conducting a Repeated Measures Multivariate ANOVA. Moderating effects of children’s gender and parental socio-economic status were investigated for each outcome. Results A significant intervention effect on children’s outcomes (multivariate) between baseline and after one year (F = 2.409, p < 0.001), and between follow-up 1 at five months and after one year (F = 8.209, p < 0.001) compared to the control group was found. The Univariate analyses showed a greater increase in the Healthy food score of the intervention group between baseline and follow-up 1 (F = 4.184, p = 0.043) and follow-up 2 (F = 10.941, p = 0.001) compared to the control group. The intervention-children had a significant increase in BMI z-scores between baseline and follow-up 2 (F = 10.007, p = 0,002) and between follow-up 1 and 2 (F = 22.245, p < 0.001) compared to a decrease in the control-children. The intervention-children with lower socio-economic status had a significantly higher increase in Healthy food score between baseline and follow-up 2 than the control-children with lower socio-economic status (difference of 2.8 versus 0.94), but not among children with higher socio-economic status. Conclusions Serving a free school meal for one year increased children’s intake of healthy foods, especially among children with lower socio-economic status. This study may contribute to promoting healthy eating and suggests a way forward to reduce health inequalities among school children. Trial registration ISRCTN61703361. Date of registration: December 3rd, 2018. Retrospectively registered.
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Affiliation(s)
- Frøydis N Vik
- Department of Nutriton and Public Health, University of Agder, Post-box 422, N-4604, Kristiansand, Norway.
| | - Wendy Van Lippevelde
- Department of Nutriton and Public Health, University of Agder, Post-box 422, N-4604, Kristiansand, Norway.,Department of Marketing, Innovation and Organisation, Ghent University, Ghent, Belgium
| | - Nina C Øverby
- Department of Nutriton and Public Health, University of Agder, Post-box 422, N-4604, Kristiansand, Norway
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32
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Vik FN, Næss IK, Heslien KEP, Øverby NC. Possible effects of a free, healthy school meal on overall meal frequency among 10-12-year-olds in Norway: the School Meal Project. BMC Res Notes 2019; 12:382. [PMID: 31277697 PMCID: PMC6612091 DOI: 10.1186/s13104-019-4418-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 06/29/2019] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate possible effects of intake of a free, healthy school meal on overall meal frequency among 10–12-year-olds in Norway. This was evaluated using a quasi-experimental school-based intervention study assessing children’s meal frequency retrospectively using a questionnaire in two elementary schools in the southern part of Norway in 2014/15. Multiple logistic regression analyses with breakfast, lunch, dinner, supper as dependent variables were used. Results A total of 164 children at baseline; 55 children in the intervention group and 109 children in the control group were included. The serving of a free school meal every day for 1 year did not improve the overall meal frequency in the intervention group compared to the control group. However, children in the intervention group had a lower odds of eating breakfast during weekends compared to the control group in crude analyses [odds ratio (OR) = 0.28 (95% confidence interval (CI) 0.09–0.84)] and in adjusted analyses [adjusted for baseline values, gender and socio-economic status) (OR = 0.15 (95% CI 0.03–0.72)]. Studies including larger study samples and therefore more statistical power are needed to further investigate possible effects of school meals on meal frequency. Trial registration ISRCTN61703361, Date of registration: December 3rd, 2018, Retrospectively registered
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Affiliation(s)
- Frøydis N Vik
- Department of Public Health, Sport and Nutrition, University of Agder, Post-box 422, 4604, Kristiansand, Norway.
| | - Ida K Næss
- Department of Public Health, Sport and Nutrition, University of Agder, Post-box 422, 4604, Kristiansand, Norway
| | - Kaia E P Heslien
- Department of Public Health, Sport and Nutrition, University of Agder, Post-box 422, 4604, Kristiansand, Norway
| | - Nina C Øverby
- Department of Public Health, Sport and Nutrition, University of Agder, Post-box 422, 4604, Kristiansand, Norway
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Howatt BC, Muñoz Torrecillas MJ, Cruz Rambaud S, Takahashi T. A New Analysis on Self-Control in Intertemporal Choice and Mediterranean Dietary Pattern. Front Public Health 2019; 7:165. [PMID: 31316959 PMCID: PMC6611428 DOI: 10.3389/fpubh.2019.00165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 06/04/2019] [Indexed: 11/22/2022] Open
Abstract
This paper completes Muñoz Torrecillas et al. (1) results and conclusions investigating the relationship between adherence to healthy dietary habits, specifically the Mediterranean Diet (hereinafter, MD), and impulsivity in intertemporal choices. Impulsivity can be defined as the strong preference for small immediate payoffs over larger delayed payoffs, and in the original study this behavior was captured by the parameter k (discount rate of the hyperbolic discount function), calculated using an automated scoring mechanism. Adherence to MD was measured by the KIDMED index and then grouped into three levels: high, medium, and low. While the authors observed that individuals in the high adherence group had the shallowest discounting and individuals in the low adherence group had the steepest discounting, the data were not statistically analyzed in depth. Therefore, the purpose of the present paper is to propose a preliminary quantitative model for this relationship and evaluate its significance. Tests revealed a significant interaction between adherence to MD and magnitude of delayed rewards when predicting discount rates. Specifically, the degree to which impulsivity decreases as adherence to MD increases is strongly influenced by delayed rewards of smaller magnitude. These findings are consistent with the authors' claims that healthy dietary habits may be closely linked with greater self-control when payoffs are small, and thus warrant further examination. The results do not indicate causality though, so future studies could also investigate the directions of this relationship as a means of developing behavioral interventions.
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Affiliation(s)
- Brian C. Howatt
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, United States
| | | | | | - Taiki Takahashi
- Department of Behavioral Science, Center for Experimental Research in Social Sciences, Hokkaido University, Hokkaido, Japan
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Haddad C, Obeid S, Akel M, Honein K, Akiki M, Azar J, Hallit S. Correlates of orthorexia nervosa among a representative sample of the Lebanese population. Eat Weight Disord 2019; 24:481-493. [PMID: 30603929 DOI: 10.1007/s40519-018-0631-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 12/14/2018] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Orthorexia nervosa (ON), or the pathological preoccupation and "fixation on healthy food" has been emerging as a new eating disorder. A limited amount of literature exists today on the prevalence of ON. The objective of the current study was to assess factors associated with ON tendencies and behaviors among a representative sample of the Lebanese population. METHODS This was a cross-sectional study, conducted between January and May 2018, which enrolled 811 participants from all Lebanese governorates. The ORTHO-15 scale was used to evaluate ON tendencies and behaviors among participants. Scores below 40 indicate the presence of ON. RESULTS The results showed that 589 (75.2%) participants had ON tendencies and behaviors. The results of the multivariable analysis taking the ORTHO-15 score as the dependent variable, showed that female gender (Beta = - 0.739), starving to lose weight (Beta = - 0.859), convincing others to follow a diet (Beta = - 0.971), thinking that eating out is unhealthy (Beta = - 0.931) and increased EAT (eating attitudes test) scores (Beta = - 0.087) were associated with higher level of orthorexia tendencies and behaviors (lower ORTHO-15 scores). CONCLUSION A highly unexpected prevalence of ON tendencies and behaviors was found in our sample. The Lebanese population might have high preoccupation behavior towards healthy and proper nutrition. Social awareness and behavioral intervention programs are warranted to follow a healthy diet and lifestyle behaviors, and consequently overcome ON. LEVEL OF EVIDENCE Level 5, cross-sectional descriptive study.
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Affiliation(s)
- Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Faculty of Philosophy and Human Sciences, Holy Spirit University (USEK), Jounieh, Lebanon
- Faculty of Pedagogy, Lebanese University, Beirut, Lebanon
| | - Marwan Akel
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
- INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Karl Honein
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Maria Akiki
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Jocelyne Azar
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- Faculty of Medicine, Lebanese American University, Byblos, Lebanon
| | - Souheil Hallit
- INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
- , Building 560, Street 8, 1st floor, Biakout, Lebanon.
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Slapø HB, Karevold KI. Simple Eco-Labels to Nudge Customers Toward the Most Environmentally Friendly Warm Dishes: An Empirical Study in a Cafeteria Setting. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2019. [DOI: 10.3389/fsufs.2019.00040] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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